Why Enbrel Support is Like Santa

You may recall my last post when I was reeling about United Healthcare’s decision to raise Enbrel from a tier 2 drug ($30 per month copay) to tier 4 ($250 per month). Right before Christmas.

Well, if United Healthcare is Scrooge, Enbrel is Santa.

After hearing the news about the drug costs going up, I sent an appeal to United. It was quickly denied. I then approached my doctor, who was hesitant to switch me to Humira, which had been newly deemed affordable by my fickle insurance. Apparently, going off a drug can make it lose it’s efficacy if you decide to get back on later. And since Enbrel’s working for me, my doc didn’t want to make the change.

Instead, my doctor recommended calling the Enbrel Support Group. I had gotten info on this when I first got on Enbrel, but because my co-pay was inexpensive, I didn’t take advantage of it.

Well, it turns out Enbrel Support has a program that will assist you in your copays. As the kind man on the other end of the phone told me (and, yes, he actually sounded like Santa): “We know Enbrel can be expensive. We want to help where we can.” I almost cried.

He signed me up for an Enbrel Support Card and told me they are starting a brand new reimbursement policy to circumvent UHC’s new stance on not taking “coupons” or support cards as payment. For the first six months, they’ll pay your full copay. After that, they cover all but $10 per month.

This all definitely seemed too good to be true. I didn’t really believe I’d ever be paid back when I refilled my prescription this week and forked over $250.

But now, sure enough, I received a check in the mail for the full amount. Thank you Enbrel Support!!

Manufacturer co-pay assistance programs are a God send for so many. When I was on Remicade the Remicare plan actually sent you a MasterCard on which they’d reimburse your co-pays. At that time my insurance was paying 100% so I never took advantage of it, but I couldn’t help think what a wonderful program that is. I’m glad you didn’t have to switch drugs just for insurance purposes. Good luck!